A Newly Modified Technique for Levator Muscle Tucking in Blepharoptosis Surgery: An Egyptian Tertiary Center Study

Abstract

Background: To highlight a newly modified technique for levator muscle tucking for the management of mild to moderate blepharoptosis.Methods: A prospective single-centre study enrolling 180 patients with blepharoptosis at Ain Shams University Hospitals from March 2017 to February 2019. Patients of unilateral or bilateral mild to moderate ptosis with good levator function (more than 8 mm) were included. Those with severe, traumatic, recurrent, mechanical ptosis, Marcus–Gunn jaw winking syndrome, third nerve palsy, absent Bell’s phenomenon, or abnormal ocular motility were excluded. The follow-up was at one week, one month, three months, six months, and one year visits. Functional outcome was assessed by analysis of the upper eyelid margin position in relation to the superior limbus and classified as very good (2 mm), good (2–4 mm), poor (5 mm) and preoperative to postoperative difference in marginal reflex distance (MRD). The aesthetic outcome was assessed in the form of symmetry of eyelid height, lid contour, lid crease presence, and degree of patient`s postoperative satisfaction.Results: The newly modified technique of levator tucking had a success rate of 92.1% in the form of a very good (77.7%) and good (14.4%) functional outcome, with highly acceptable aesthetic outcomes: symmetry of eyelid height in unilateral cases (86.1%) and bilateral cases eye (84%), lid contour regularity (91.6%) and lid crease symmetry (88.8%). Postoperative patient satisfaction was 83%, with a short operating time of 27.4 ± 4.6 minutes per eye.Conclusion: The newly modified technique of levator tucking is a rapid, simple, highly effective technique, with less recurrence and high patient satisfaction.Trial Registration:· Trial registry: ClinicalTrials.gov· Unique identifying number: NCT04883853· Date of registration: 11/5/2021 (retrospectively registered).